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      Palliative Care in Enugu, Nigeria: Challenges to a New Practice

      Indian Journal of Palliative Care

      Medknow Publications

      Challenges, New practice, Palliative care

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          Abstract

          Everyone, young and old, male and female, rich and poor, should have access to excellent care during the course of a serious illness and at the end of life. Therefore, a denial of such care becomes an infringement of the individual's human rights. Because of the efforts of pioneers in this field of Medicine in Africa and beyond, both living and immortalized, we can now say that palliative care in the African context is affordable and achievable. In this article, some of the challenges faced in setting up and running a new palliative care practice in an emerging and developing economy are examined.

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          Most cited references 36

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          World Health Organization.

           Ala Alwan (2007)
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            Role of radiotherapy in cancer control in low-income and middle-income countries.

            More than half the cases of cancer in the world arise in people in low-income and middle-income countries. This proportion will rise to 70% by 2020. These are regions where the annual gross national income per person is less than 9386 US dollars. Radiotherapy is an essential part of the treatment of cancer. In high-income countries, 52% of new cases of cancer should receive radiotherapy at least once and up to 25% might receive a second course. Because of the different distribution of tumour types worldwide and of the advanced stage at presentation, patients with cancer in low-income and middle-income regions could have a greater need for radiotherapy than those in high-income countries. Radiotherapy for cure or palliation has been shown to be cost effective. Many countries of low or middle income have limited access to radiotherapy, and 22 African and Asian countries have no service at all. In Africa in 2002, the actual supply of megavoltage radiotherapy machines (cobalt or linear accelerator) was only 155, 18% of the estimated need. In the Asia-Pacific region, nearly 4 million cases of cancer arose in 2002. In 12 countries with available data, 1147 megavoltage machines were available for an estimated demand of nearly 4000 megavoltage machines. Eastern Europe and Latin America showed similar shortages. Strategies for developing services need planning at a national level and substantial investment for staff training and equipment. Safe and effective development of services would benefit from: links with established facilities in other countries, particularly those within the same region; access to information, such as free online journal access; and better education of all medical staff about the roles and benefits of radiotherapy.
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              Paediatric palliative care: challenges and emerging ideas.

              Paediatric palliative care is an emerging subspecialty that focuses on achieving the best possible quality of life for children with life-threatening conditions and their families. To achieve this goal, the individuals working in this field need to: clearly define the population served; better understand the needs of children with life-threatening conditions and their families; develop an approach that will be appropriate across different communities; provide care that responds adequately to suffering; advance strategies that support caregivers and health-care providers; and promote needed change by cultivating educational programmes. Despite these challenges, advances in paediatric palliative care have been achieved in a short period of time; we expect far greater progress as the field becomes more formalised and research networks are established.
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                Author and article information

                Journal
                Indian J Palliat Care
                IJPC
                Indian Journal of Palliative Care
                Medknow Publications (India )
                0973-1075
                1998-3735
                May-Aug 2011
                : 17
                : 2
                : 131-136
                Affiliations
                Department of Anaesthesia/Pain and Palliative Care Unit, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Enugu State, Nigeria
                Author notes
                Address for correspondence: Dr. Tonia C Onyeka; E-mail: doctortonia@ 123456yahoo.com
                Article
                IJPC-17-131
                10.4103/0973-1075.84534
                3183602
                21976853
                © Indian Journal of Palliative Care

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Review Article

                Anesthesiology & Pain management

                palliative care, new practice, challenges

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